the consequences cannot be your destitute. i just you and i think it should be aa lifestyle a way of life. our safety net is failing. the purpose of our anti- poverty for should be secure poverty. a better approach is the 1 i have argued, we should take our money and allow it to be spent at the state and local level so they can design innovative programs that work in those communities that specifically target the causes or leading causes of poverty in that community. the only requirement i would have is that anyone receiving public assistance should be working or going to school. any solution to poverty has to involve not just paying there terms in the short-term butshort term but the acquisition of skills you need. and so that is why i have argued our safety net

program should be reformed in that direction, and i have also argued for a wage enhancement credit that would allow an individual to receive an extra $4 an hour because at least they're working. the longer you are unemployed the harder it is to give reemployed again. we have offered a number of innovative solutions to deal with that. the government obligation is to create systems for individuals have fallen on hard times can get back up and try again. in some cases it is a lifestyle and in other cases system that traps you. we need to cure poverty and are not doing that right now. >> thank you for your emphasis on innovation. i can tell you firsthand startups have trouble. our local universities train

a lot of foreign-born students, some of whom are undocumented,, like i have been since the 1st grade. as president what would you do to help foreign-born students and dreamers like me who want to stay in this country and work in this country? >> i believe we need to pass immigration reform. i just don't believe we can do it in one massive piece of legislation. the reason i know that is because we tried. the only way forward is to say to the american people, we recognize we have 11 or 12 million people in this country illegally but will stop the problem from continuing to grow. step one has to be to prove we brought illegal immigration moving forward under control and modernize legal immigration so that it is more reflective of the 21st century which would be helpful. after we have done those two things the american people

will be very reasonable and how you deal with someone who has been in this country for 2020 years old was brought here is a child who is not a criminal. what do you do with someone in that circumstance? depending on your circumstances you have to come forward and pass a background check. pay a fine for having violated the law. you get a work permit. and after that. has expired i am open. that will have majority support in this country.

>> and they know. >> to bring back your refrigerator example and andrews volkswagen example, where do you stand on the right to repair. for instance, john deere prohibits only -- only allows authorized dealers to repair things. samesame thing for apple. >> or you lose your warranty. >> there are also very restrictive terms of service. is it possible you brought the -- bought the wrong brand of refrigerator? you know, many independent contractors are building this. the terms of service and the policies don't really allow. >> i have not thought about

it in depth. i have not thought about that unique aspect. again, as we move forward in this conversation about innovation, these are the sorts of issues we have to work through. any economic transformation involves significant disruption to the workforce or regulatory schematic and we will have to work through these. that is an impossible task in the counterproductive one. and does not mean it will be seamless or without disruption,disruption, and i'm sure we can work through many of these. but we have no choice but to do so.

>> i bought a knew one. they basically said keep the old one and send a knew one. things are changing. please think i senator for joining us this morning. [applause] >> all campaign long c-span takes you on the road to the white house.

>> the founders use the language of the ancient republic greek and roman.

and warnedrome. and warned against corruption. and there definition of corruption was not bribery or quid pro quo money under the table. it was putting special interest of the common good. by that definition washington is a massively corrupt place. >> the senate voted to advance a house-senate compromise on 2016 defense programs. this sets up the final vote tomorrow. here is debate with senator jack reed, john thune, dick durbin, and john mccain. this is 40 minutes. done. a senator: mr. president? the presiding officer: the senator from rhode island. mr. reed: thank you, mr. president. mr. president, i rise to discuss the conference report on the the conference report on the >> the sen.senator from mr. -- from rhode island. >> thank you, mr. president. we will be voting on this in the next hour. this report is the product

of months of negotiation and compromise between the house and senate, andcommand i want to commend chairman mccain, thornberry, and ranking member smith for a thoughtful,a thoughtful, inclusive, and cordial process. and there are many provisions that provide for service members and their families. 38 billion request about the president for enduring baseball term requirements essentially skirting the law known as the budget control act. again, this is a maneuver to

get around a statutea statute which was signed by the president and voted for by congress which has imposed budget caps on every department and center to that agreement was the consensus, significant consensus using it in a way it was not intended to be so used. fully funding the defense department without breaking's imposed by the bca on defense and nondefense. however, it provides no relief. that includes many agencies critical to national security.

force a bipartisan compromise her ongoing budget difficulties. emergency funding is outside budget sure reason. an unacceptable use of this important tool for war fighters in the field. it complicates the dod's budget problems.

it does not provide the certainty instability it needs building its five-year budget. it is a useful metric because it evolve all they were deploying troops overseas in response to afghanistan and enduring freedom than with respect to a rack and there is a correlation in the minds of most people between our efforts overseas the troops engaged approximately 187,000 soldiers deployed.

roughly 930 people. so this increase has gone someplace. had we gone overseas directly to the men and women who are fighting, but has gone to other accounts. in addition to this phenomenon within the next few years services will begin procuring new weapon systems. 10.6 million.

as the capture made in place tough budget choices will need to be made. we will have a choice of not investing fully and the necessary strategic improvements or using legacy systems which are so important to pay for them. tough choices. alternatively and more likely, these programs will be funded in the base budget. however, to ensure the budget caps on outreach funding will be shifted from the operation and maintenance. in order to accommodate increased procurement for knew weapon systems which is in many respects what is happening with this money shifted from the traditional base budget into budget

accounts for owen and requirements. what you have here is, in a sense, a budgetary sleight of hand. we have increased demand because we have to recapitalize our strategic systems particularly. and if we have the bca caps in place we have to find money someplace which is likely to be the account, and we will see a fund which was designed to support ongoing operations overseas suddenly be the pay for long-term base budget items, i.e. recapitalization of our current structure forces. and if we use this game this year may be with good intentions and the intentions of just one year to get us ahead, it will be easier to do it next year and the year after and the year after that, ensuring that this balance between security and domestic spending continues. as we all recognize, effective national security

requires non- department of defense agencies receive relief. the pentagon cannot meet the complex set of security challenges without the help of other agencies including state, justice, and homeland security. undersecretary of defense policy christine moore made this point just a few weeks ago. to testify on a strategy to counter i s il. it will take more than just a military campaign to be successful. we need help to drive the finances of kayfive, stop the foreign flow of fighters into iraq in syria, protect the united states from potential isil attacks

and find ways to more effectively counter the very successful missions and campaigns of isil. unfortunately we will effectively diminish our national capabilities to do all of these things by underfunding non-department of defense departments and agencies that are critical to our national security. facilitating underfunding most apartments. we need an all-out governmental effort to provide for our national security. underfunding state and treasury and other departments is not going to get us that effort. and when you no longer becomes easy to underfund suspense agencies, my agencies, my suspicion is they will begin appearing in our code. and there is some precedent to this.

adding funds to the defense bill. the follow-on legislation of 1985. the situation where your in discretionary domestic spending was on. this is a situation that we are re-creating in this conference report. the congressionally elected medical research program, and every senator is familiar with this important program. they send hundreds of millions of dollars. in fact, this program has received over $13 billion in funding.

the department of defense does not execute any of the money itself. it is a competitive grant process review criteria and essentially the money goes out to medical research facilities throughout the united states. it is a medical research program much like we funded throughfund through nih. and i am a strong supporter of medical research. and indeed this program has saved countless lives. my concern is that under the aegis of a ocl approaches like this, budgetary maneuvers like this will become common.

should be properly budgeted. this approach would circumvent the budget control act. fill a responsibility to the american people to fully fund the government however,

i believe this is too important. as secretary of defense carter said last week without a negotiated budget solution in which everyone comes together at last we will again returned to sequestration level funding, reducing discretionary funding to its lowest real level in a decade despite the fact that members of both parties believe this result will harm national security. making these kindmaking these kind of indiscriminate cuts is managerially inefficient and therefore wasteful. a danger to our strategy and frankly is embarrassing and from the world.

mr. president, the bca was created to address the immediate threat of what would have been a catastrophic national default and compel congress to come together and reach a balance compromise for the budget. it is time for congress to make the hard choices and modify or limit the caps to bca and in the threat of the -- threat of sequestration. it is not just an appropriations issue but affecting everything we do. do. unfortunately it affects the fy 2016 national defense authorization act and therefore i will not be prepared to support this legislation. with that i yield the floor.

>> mr. pres., democrats has spent a lot of time talking about the importance of keeping the government open. mr. president, senate republicans could not agree more. congress has a responsibility to ensure our nation's priorities are funded command we spent a lot of time working on that. by the end of july the senate relations committee agreed to approve all bills says 2,009 for the 1st time, for the 1st time in

six years they approved all 12 appropriations bills. there is one problem, mr. president, for all there talk about providing for the government democrats are reluctant to take any action when it comes to passing these bills through the senate. republicans try senate. republicans try to bring out the military construction and veterans affairs appropriations bill last week. senate democrats he spent weeks talking about funding the government refused to allow the senate even debated bill that would fund military construction, protect our homeland and keep the promises we have made to our veterans. shut up the process of his

legislation. the veterans affairs appropriations bills debated in the appropriations committee for members of both parties given an opportunity to offer amendments in the help save the contents. the bill passed out of committee the democrats had allowed theallow the bill teresa floor. they would have another opportunity. they would not even let the bill come to the floor to be debated. they block the motion to proceed to the bill that would allow us and them an opportunity to be heard and offer amendments.

the bicameral agreement that authorizes funding. and like the bill democrats block last week this legislation which is the product of the bipartisan committee process and received bipartisan support coming out of the committee. more than that, it received strong bipartisan support on the floor when i 1st came it 1st came up for consideration in june. this bill, the defense authorization act was reported out of the senate armed services committee, came to the floor, united states senate, received a big bipartisan vote but now

some of the very same democrats are planning to vote against it. on top of that president obama has threatened to veto this bill when it comes to his desk. why are democrats opposing a bill that would authorize the funding our troops need to operate. historically the national defense authorization act has received strong bipartisan support,support, and there is a good reason for that. historically both democrats and republicans have known that the great responsibility that we have to the men and women who keep us safe, and we have made a habit of working together to try to meet the responsibility. so why are things different this year?

we had hoped that they would rethink their strategy. all 12 appropriations bills reported on the senate appropriations committee with bipartisan majorities, collaboration, and but from both sides, amendments offered and amendments voted on. unfortunately this past week it has become clear we won't fund the military until we get whatever there domestic priority is.

itis staggering to think that some senate democrats would think of blocking the national defense authorization act after supporting this bill in june. let's remind ourselves what it is they are voting to block and what the president is voting to veto. authorizing funding for nations military and defense from equipment and training for soldiers to critical national security priorities i supporting allies against russian aggression overseas.

farmers have played a key role in armed conflicts the united states is engaged in over the last 20 years. they flew halfway around the world libya, drop their bombs and returned homes on a single mission. without this act the funding levels needed the weapons

and planes the military needs to defend our country. it also represents the future of our bomber fleet. by vetoing this bill he would be vetoing a number of critical reforms for instance, this year's national a target is 10 billion in spending and redirects those funds to military priority. the bill implement sweeping reforms by removing the bureaucracy.

it implements a number of reforms to the pentagon's administrative functions. it changes the emphasis of the department of defense from administration to operation which will help ensure our military personnel receive the training their need. the current military retirement system limits retirement benefits to soldiers who served to 20 years or more which is not applied 83 percent of those who observed. the national defense authorization act replaces

the system with the modern retirement system that would extend benefits to 75 percent of our service members. mr. president, no time, no time is a good time to veto funding for our nation's troops. but with tensions in the world where they are, decision by senate democrats and the president to block these funding educations, isil is carving a trail of slaughter across the middle east. thanks to the presence nuclear deal. will have access to increase funds. funding terrorism in the iranian revolutionary golf,

that same deal ways the sanctions on the iranian leaders including general solomonic was responsible for the deaths of american soldiers in iraq, yet the president is threatening to veto benefits. the president still gives hezbollah and hamas more funding to spread terrorism. missile-defense systems for our allies. president obama is threatening to veto funding for our advanced weapon systems, us military forces giving iran access to conventional weapons advanced nuclear centrifuges. holding up funding for our

troops by blocking this authorization bill is unacceptable. senate democrats and the president may have decided to pursue a strategy of distraction. a national security priorities. they will rethink their opposition and joined republicans in supporting this critical bill. i yield the floor. >> how much time is remaining on the democratic side? >> five minutes. >> i think the chair. the conference committee report on the house defense authorization bill, not the spending bill with the authorizing spending, a bill that largely is bipartisan, no argument on either side of the aisle to support our troops, no argument on providing the technology and

weaponry, but the issue before us is a larger budget issue that goes beyond the department of defense but includes it. put in 37 to $38 billion a made up money 37 and $38 billion of what is known as a ocl funds and assume it is there and put it in the budget for the department of defense only,only, but they do not put money in for nondefense agencies. they adequately fund the department of defense, generously funded and then cut back in the rest of government. what iswhat is the difference? what difference does it make? well, the cutbacks include on the nondefense side medical research at the national institutes of health.

keep a promise to the men and women who served the military, the cuts include keeping america safe when it comes to homeland security and the fbi. they make cuts in these agencies but provide funding for the department of defense. we argue, let's have some balance. we want to give our troops the best treatment, but we do not want to shortchange the other side of government, the nondefense side which is with the budget negotiations are all about. republican after republican says the democrats just don't care about the military. it is not true, but there are other parts of the government that are important as well for the safety of the united states and the future of the united states whether it is education or medical research or caring for our veterans. let's have a balanced budget that acknowledges the reality and let's look at a

couple of other things that are realistic. they have proposed in the house of representatives the carter from alabama opposed the military so 100,000 45 caliber semiautomatic handguns 289 americans are

injured each day. ninety-seven lose there lives. we saw this terrible tragedy last week. i was stunned to hear and npr over the weekend that what happened in oregon was the 45th school shooting in america this year, the 45th this year. it will be solved if democratsthe democrats and republicans start looking for reasonable ways to limit the access of guns from those who have a history of committing criminal felonies or a history of mental instability.

i am glad that the senate conferees has cleaned up his house provision that would have dumped 120 handguns into the hands of purchasers without any kind of background check. we are committed to our military and the defense of the united states. we would monitor it for the sake of not only israel but all the nations. we want to make this a safer world. turn to the policy before we return to a military response. i hope in the closing minutes of debate that members will reflect on the fact that we can have a better deal for not only to help our military but to help those others who are funded by the nondefense side of the budget to have

some balance and make sure it is not lopsided with the money all going to the department of defense and technology precious needs acknowledging precious needs of america in many other nondefense subjects. i yield the floor. >> the senator from arizona. >> mr. president, i say with respect to the senator from illinois, he just authenticated an old saying, talk is cheap. this is one of the more remarkable performances by the other side. legislation that is vital to the welfare of the men and women serving in uniform. should not take care of him because he has another problem. that is a logic that defies anything i have observed a long time. this is an authorization bill. hashas nothing to do with the appropriations process and the money that needs to

be spent are not spent on any kind of mechanism. the senator from illinois and a senator from nevada, the democratic leader, you keep talking about the fact that the budgetary passed by the budget community a majority vote here in the united states and on the budget calls for additional funding for defense, and so now in direct contravention to that my friends on the other side of the aisle object to that provision in the budget act and will now oppose legislation that authorizes a pay raise for our troops, special pay and bonuses to support recruitment and retention, make healthcare more affordable, increase access to urgent care families.

maintain access to the medicines they need as they transition from active duty. there are literally tens if not hundreds of provisions that take care of the men and women who are serving in our military. turn this down. please don't say that you support the men and women in the military.

i don't like it, i hated sequestration. while vladimir putin does members russia and my college and the other side of the aisle are not complaining that they did not like the way it was funded.

shown this remarkable leadership with the insertion of russia into syria, which she did not find out from his meeting with vladimir putin of 90 minutes which is secretary of state has said is an opportunity colleges secretary of defense said was unprofessional. they are now slaughtering, slaughtering men, young men fighting against isil and a sawed and the russians dropping bombs on them.

my colleagues on the other side of the aisle will urge a no vote. for the 1st time in 53 years53 years on an overall: on specific issues from abroad issue of the budget my friends want to turn down our authorization and our responsibilities to the men and women who are serving in the military. i urge my colleagues to rethink their misguided logic, attacked the appropriations bill. let sit down and try to negotiate an agreement that takes care of all of these other aspects of our government. but let's not do this to the men and women who are serving. prevent us from improving our quality of life.

>> i urge a high vote on the motion to proceed i suggest the absence of a quorum.

>> every first lady should do something in this position to help the think she cares about. everything in the white house should be the best.

so is our feeling for children. >> it was ultimately the tragic images of president kennedy's assassination funeral that cemented her in the public mind. the original series 1st ladies, influence and image, examining the public and private lives of the women who fill the position of 1st lady and their influence on the presidency. american history tv on c-span three.

>> the senate veterans affairs committee held a hearing on several bills related to providing health care for veterans. >> i would like to give a little preannouncement. in the interest of everyone on the panel, as soon as we have eight members we will go into session so we can get on with the nomination. if you don't mind, i will

interrupt you for a brief time. please to have three members of the senate to discuss legislation they have proposed and two distinguished panels to comment on their legislation and are delighted that you are here. and i appreciate the ranking member and the cooperation moving as quickly as i have. west los angeles. >> in the interest of our colleagues time i want to

thank you for being here. these measures are very worthwhile, and we look forward to your testimony. >> each member will get five minutes. as soon as you have made your testimony,testimony, if you would like to be excused, you are welcome too. >> thank you very much, mr. chairman, ranking member blumenthal. i am going to speak today about the los angeles homeless veterans leasing act, a bill i introduced with senator boxer. i would like to thank david norris from the california chapter of the veterans of foreign wars for traveling to washington to testify in support of our proposal. thisthis bill would allow a facility which is a very large facility, 388 acres on wilshire and san vicente, the north side of those for

is a veteran veteran cemetery, and on the south side is a very large complex including a hospital, several buildings, a ucla baseball diamond then do any other things. it is run down, needs help. now, the majority of veterans, the largest number of veterans in america actually live in los angeles. there are 3,000 of them in more than 4,000 have no place to go. they are in fact homeless. congress took that authority away after it became clear

that leases were granted to commercial entities that were not serving veterans. this included everything from movie lot to a laundry facility. the problem led to a 2011 lawsuit which was settled earlier this year, but now thanks to the leadership of veterans secretary bob mcdonald, we are back on the right track. since he has taken over we have spoken many times about the issues la veterans face. he has put an excellent new team together. i met with them in los angeles last month and was thoroughly briefed. i believe we now have a path forward to make sure the campus forfulfills its obligation to serve the veterans, and here is why. this land is a grant from a former senator by the name of jones command he been the family in 1888 which said that it has to be used

exclusively for veterans. so at a certain time facilities were rented out to a lot, aa laundry, rental car business. well, that is not for veterans. this enhanced police would enable the va to use nonprofits and thereby access about $600 million of the state of california's money which has been specifically earmarked for veterans on that facility. at present that cannot be done. it is an essential tool to implement the new master plan.

i also want to thank this committee. you authorized funds for the 1st building for homeless. fifty-five units, $35 million for the 2nd building, and the thrust is to allow nonprofits to come in for the specific purpose of building veterans housing. and, so i am hopeful -- let me just.a couple of things out. new lease is must be consistent with the master plan. the office of inspector general will regularly report on any new leases and land-use agreements. ifif the va is not in compliance new leases will be prohibited in the va must submit a report to congress 4545 days before entering into any new lease agreement i truly believe that this plan will help turn the page and ensure that we are doing everything we possibly can for veterans in los angeles

going forward. mr. chairman, i would like to answer letters of support from local officials,officials, homeless advocates, and veterans groups into the hearing record. we intend to move forward executive committee for considering the nomination of labor. i recommend the ranking member. >> mr. chairman, now that we have a quorum present make the following notion. favorably support the

nomination to be assistant secretary of labor. >> thank you for holding this hearing today. ii appreciate the opportunity to speak briefly about my legislation. mr. chairman, as you know, the suicide rate is not just a tragedy. it is a crisis. we lost 433 member service members to suicide nfc more than 200 in the 1st half of this year and were

painfully aware of the statistics the 22 veterans every day take their own lives. we have lost too many veterans to discourage. each member of the committee can say the same about your home state. despite the time and effort we have put into combating military and veteran suicide these numbers and the stories of each of these preventable deaths tell us how much more work we have to do. the key challenge is tackling this problem with a clear eyed understanding of how stigma, provider shortage and budget restraints impact on service members seek care. we took an important step last year, part of the national defense authorization bill. this year i am working with several republican colleagues. improving the accessibility and quality of mental health care.

i am here to talk about one of those care package bills that is on the agenda. i have been working with my colleague who is experienced and insight is a veteran and officer in the iowa army national guard has been indispensable. ..

>> >> multiple internal reviews of dod anand v.a. have identified the need of cultural competency in the use of dod v.a. clinical practice guidelines to enhance the quality that is received from community providers. i have a few examples here today the suicide task force report the assessment of ptsd treatment is called ready to serve read no more

and more veterans will seek care from on the providers we need to beecher as many of those as possible our trade to provide high-quality care and we need to give them tools to make decisions where to seek care whether not there using benefits with evidence based therapies for providers it will come as no surprise the uptake needs to improve in any better incentives to produce a paper co may already grant continuing education and credit to require trading but they cannot be in the network so much as they complete that at a time when our vets and service members need options

s-717 is for writers to access specific trading to receive a friendly designation if they with other requirements. the program has now expanded to seven states as you know, george is one of those states and it is an extraordinary program. they were included in the conference report. can i have an additional 30 seconds? thank you. the sooner we keep it intact the legislation but only for military personnel not for veterans. this deals only with their program as it impacts dod it does not address veterans by

the department of veterans affairs i am here today asking to work with all of you to insure those services are available not only to military personnel but those that we care for so much. thank you for your time. >> i appreciate your testimony. >> the key for holding this hearing today give the opportunity to use speak with a number of judges and u.s. court of appeals. does every member knows one of the most complex challenges facing this committee will be their growing backlog of veterans denied benefits continue to face a complicated and frustrating prolonged process so those awaiting

appeal is staggering is that the highest appellate level in over the past four years the number of disability claims has increased 65% from 49,000 the board is now receiving twice as many claims as it has the capacity to decide to begin in the year with 65,000 unresolved cases over the course of the year to receive an additional 56,000 cases. the average arunta of days to resolve the case is from june 89 between 335 i have

spoken with veterans in new hampshire who have waited even nine years to resolve a claim and as the matter of basic fairness we have got to do better to take a serious look of the appeals process the bill is very simple to reauthorize the court of appeals to employ nine judges instead of seven. since 2002 congress has granted temporary authorization to increase that nine judges before that it was authorized at seven but that authority ended and as a result has read and used at eight and will return to seven if we do not act soon. the court noted in the annual report that given the anticipated increase seven the precision's decisions to

be rendered in now is not the time to reduce capacity. i urge the committee to support the simple measure to provide help to the crisis and how we streamline the appeals process in the future. thank you very much. >>. >> we have to distinguish panels the assistant deputy undersecretary with u.s. department of veterans affairs and refers panel please come forward.

>> ag for testifying today. you have the floor. >> the afternoon. they give we're the invitation to present our views on several of the vote -- bills that with such benefits is in the services. and it to introduce senator feinstein for introduce the of the veterans homeless act of 2015 those for barbara boxer. the bill would authorize v.a. for agreements for veterans' housing and services.

to help and veteran homelessness this legislation will help in three ways first to enter into agreements with local partners for those families that are at risk for homelessness. and allow the va into a rich and vibrant community to ensure the underlying transfer property to the federal government with a healing environment for veterans with a forward to working closely with each of you and other stakeholders with the implementation also

supporting as 2022 for medal of honor recipients to recognize the extraordinary bravery that the medal of honor recipients of previously it is demonstrating our commitment and gratitude. also the veterans' housing stability act of 2015 and with homeless veterans and their families. and work with the committee for cost of a later date there are other provisions that are not needed or for further discussion with the committee is are highlighted in the of a written statement. s-717 to establish a special

designation with mental health care providers with military a culture it does not support the provisions of this bill to recognize the need will to be equipped with the necessary education to retreat or nation's veterans. that with the community provider tool kit that accomplishes the intent of this bill it edition and requires the va to have non department providers well we acknowledge this will be helpful to possess military training with the certification to maintain

and with respect the court of appeal support act we will refer to the court division still be enacted as a primarily affects the court and not v.a. operations. the delivery opportunities for care and services to address issues related to medical education and training to retention of leadership to work with the committee on a later date. thank you for the opportunity my colleagues and i would be phased to answer any questions you may have. >> i will begin the questioning. >> day you have the master

plan? >>. >> the 22nd is the date. >> master plan on october 15 were surely there after in and around the 21st we should get something to the committee. >> is the comment period 60 days? >> we are proposing it is still being debated is between 30 and 60 days for public comment since it does that incorporate the baseball stadium at ucla? >> it does not directly incorporate the stadium is of partnership that is the academic if eliot but the

focus of this is for the services to address the stadium but it doesn't give any special provisions. >> the is the two most controversial aspects but it is to make the property veteran focused. >> party to put a lot of hot seat if you submitted by the 22nd of october a master plan can you deal if the v.a. will recommend the baseball stadium? >> it looks at how the campus could be revitalized as a community and it will talk about how all the different zones could be best utilized with the

continuation through this alone process which is separate discussions from the master plan as well as the ongoing discussions how we can provide services under veteran focused to be a focus on veterans. says the byproduct of the discussion. >> when the property was conveyed to the v.a. 1888 was that not covenant all of the deed? >>. >> we have been very clear

through the master planning the we have undertaken back in january. to make sure it is stated the our 21st century it is the prior eight of the veterans. >> but the west l.a. property is there potential revenue to the government around the country that the v.a. owns but this master plan may be a template for the future of other properties that our vacant that could be leased to generate revenue. by that master plan will be critically important rate

think this could be a template and wte think this could be a template and what to be focused on 21st century health care with the other services that dignify the men and women in this country. >> and it is hearing is important dealing with mental health and homelessness i appreciate all my colleagues efforts ranging from those issues to their recruitment of health care professionals there is a pressing need to move forward in that want to

offer my strongest support for the bills mentioned by my colleague as well as for senators one dash senator testers act to enhance of medical work force to tackle the problem of vacancies in that which we have offered the housing stability act there is some provisions and that you do not support in this measure will you tell me why? >> there is one provision that we do not support which is section three which could require v.a. to create a new program for homeless

veterans and at least six locations v.a. feels we already have a strong program tied to the head -- h e d but there are other opportunities for of reach for veterans and homeless veterans at this time we have been extensive network to soup kitchens and prisons there is analysis that is done to make sure there is a focus on the population and indeed. >> you feel that reaches sufficient? >> we do. >> i would respectfully disagree. glading there is a need for more our reach from but i have seen in connecticut although we are on the verge of reportedly anteing front-line homelessness in connecticut there is a need for our reach every day but apparently it is lacking or

inadequacy why would urge perhaps you consider working with me on that issue. money ask you about the of veterans court when understand you don't run the court of appeals but wouldn't you agree about backlog and the caseload warrant this step? >> it sounds compelling that i feel we are not in a position to decide for the court but i acknowledge there is a backlog and there could be additional value. >> perhaps you could consult with the va to get back to was in writing on this issue it is within the purview of irresponsibility to the benefit of the veterans are

processed as expeditiously as possible. >> yes, sir,. >> finally delivering opportunities for care and services for the act that is sponsored by senator tester and others could you restate your position? >> the v.a. has not developed a formal position but mckeon sections 101 and 102 that deals with residency use the provisions we feel strongly to allow was to develop more residency programs to have the potential to recruit residents to provide care for veterans also looking at

section 300 that deals with additional provisions to put a network directors under title 38 mulally yes to be more competitive as we recruit to address complexity challenges facing our locations these will all be very positive actions to be competitive in the health care market today. >> i am a co-sponsor of this measure i think it is vital and i want to thank senator tester for his leadership. thank you. >> mr. chairman i just want to follow-up on the proposed legislation it would appear when does a lot to help health care long-term and i

am curious you indicated you did nnd i am curious you indicated you did not have a position the you just gave seven reasons why you would support it i would like to go more "in-depth" tell us the reasons why you're not interested to support it. >> we're not in that position but we just have not developed our views in a formal fashion at this point. but looking at the provisions and sections of the bill i see there are opportunities particularly at oral health identified the residency positions focused in highly rule areas over the last year if we were able to get 400 request for residency positions, 204 met a the requirements 163 have been filled the we will fill the rest with the

academic year. proving for is to begin to work with smaller medical centers and the osteopathic schools will require time to develop those residencies and then to get it accredited then to fill the residency there is an advantage to expanding for five years up that 10 years. >> it sounds like a bureaucratic mess. 717 it is the proposal you indicated it was not okay for those who treat the armed forces as providers with knowledge to the health care i am curious filicide

the veterans stepping now i suspect if they could go directly to dave v.a. facility they would look at that but yet with this particular proposal those that could not access the facility you indicate you have other alternatives out there that our comparable. in his scenes of it is working right now we would not have the request. are you thinking with that alternative proposed by the legislation? >> deposition is there is a

need to educate the community to have vehicles out there to provide that education also a embarking on the defense authorization act to begin to reach to provide mental health services we don't feel we can adequately developed a program to recognize somebody because well they take the training it is difficult to determine the competency and long-range if they maintain that competency. >> good hard-working individuals you don't start off with a program in which you train them to begin with you provide them with training courses right now

it seems that same type of approach would be comparable with these other non v.a. facilities the we would consider the position in those parts of the country that don't have access to the expertise. >> i appreciate your support senator boom in paul on this bill. simply put this was to address the chronic shortage and allow you to better compete for the skills that you need as v.a. continues to get pressure for more services. as background to incorporate

ideas from veterans and medical communities everyone from medical colleges to physician assisted in the american legion in july reported on provisions from this legislation and want to highlight the section regarding medical residency to get a pipeline into rural america to address our veterans' needs. congress included a provision over the next five years but to date a cannoli

fell 163 of those positions? so after speaking with folks in the b.a. it simply cannot happen is that a fair statement? >> it is. >> because it no longer runs its own program with its own affiliates to establish? >> we need to partner with academic partners our community hospitals. >> but the affiliate's are hamstrung is that correct? >> that cap was established

it is insufficient to meet the needs that are out there and that is why it would establish those residency positions it could make the made - - education payments when think it is critically important if we address these medical needs on the ground but absolutely has benefits to rule of america. leading to more partnerships to joy and though work force does it give yourself the tools that you need? >> against the extended time frame to develop a residency

particularly n roll areas -- rural areas this will allow us to have reached. >> is this a strategy? >> i think it is a good strategy. >> i want to talk about the other section 300 very quickly to make sure that folks are held accountable but do you believe this is ben the ability to compete with the health care industry can you give me the

indication of that gap? >> on average i don't have those numbers but i can tell you the salary paid in the private sector was significantly greater than what we pay our directors. >> what kind of vacancies do you have now with the medical director? >> i think that is 25 or 30% >> less salary or that they don't have directors? >> didn't have directors. >> but it is a huge problem

we would love to have your help as we move forward think he for your hard work there are far too many i appreciate your bringing that up. >> i would read the second that. is this something we simply have to do but i do know it is difficult to the situation. dr. lynch to support his legislation the idea that to provide the medal of honor winners with the small pension but one of their

real the use that these are individuals that have had the opportunity to be around as you see people of all ages with a positive experience and one of the problems is that many times it is that our own expense but may times it is the expense incurred by itself and it is difficult so that is another reason the legislation is beneficial. do you agree with that to help us highlight the sacrifice in importance of

the military? >> absolutely. >> very good. >> the understand your not supportive of of senator not only in the legislation concerning designating on mental health care providers who treat members so tell me about that it isn't uncommon through the medical societies wise is so difficult for the v.a.? >> i think v.a. and dod looked at this with respect to another program related to mental health services in rural areas and found this was legal obstacles also

potential conflicts for state licensing with the review board's so one aspect is legal the other develops a process to allow us to assess competency beyond the self administered educational program and to follow the progress of their treatment over time we don't feel we have the resources to do that properly right now. >> i would like to visit with the psychological association to figure that out. and mental-health care issues are a crisis in the past year reaching the

breaking point now so we have to start thinking outside the box. it is something i would appreciate you see how we can expand the services we are providing but it is very difficult to provide the service without ancillary help that is why the medical societies potentially. >> thank you very much for your presence today and may be following up on what senator bozeman was talking about but i want to explore the issue of the use of community mental health providers within the up to each of. -- within the v.a. under the choice act is required to

provide services for those who cannot receive it within 30 days or live more than 40 miles away from a facility that now has been redefined. >> yes. >> won the deal replaces in kansas to access mental-health services are a community mental health centers to provide the wide array of mental-health services and my impression is working on this long before choice was an active but trying to get v.a. to receive care through there it had not developed. my question is with today's circumstances required, the be the bottleneck is how the

v.a. or tri-west decide to to contract with. can you explain how the process works? >> to my understanding, a tri-west on behalf of the v.a. reaches out to providers in the community to engage them with the choice program. there are some requirements requirements, they have to be medicare eligible to participate. they have to provide a copy of their records within 30 days for services. we can reimburse them at rates up to medicare. lot of the challenge is related to working with the providers getting them to engage in choice. we have been working with tri-west to improve those in

working to try to make it easier through recent legislation that would let us work within the 30 day interval with the reauthorization is to make the process easier to implement with recommendations going forward as of november 1st to help us greatly integrate the v.a. care in the community beyond right now. >> is there any circumstances that the v.a. decides we don't want to have an outside provider provide this kind of service there for tri-west never enters into negotiations with the provider? >> not to my knowledge as long as they meet the provisions. >> it is and the attitude that says we want to retain the ability only revenue is not the right word but the revenue that flows from the veteran we want to maintain

that and not allow psi provider to provide that service? >> no. the secretary has made it clear we're coming into a new era. we need to collaborate with the community and partner with them to provide care and we cannot do what all are self. >> one of the health centers in kansas told me they were allowed to contract but only by screening services but not the actual care of the veteran. does that make sense? to receiver interested to provide the care but the v.a. says no we will only contract allow you to do screenings. >> i don't understand that better be happy to get more information. >> you have the sense that this implementation of the choice act is uniform across the country?

>> it does vary across the country depending on the ability to recruit community partners but reworking aggressively with the third-party administrators to engage the community to have choice providers available. >> under the klay hunt act your instructed to provide additional little whole community services any development there or does that choice act take care of that mandate? direct will have to look at those provisions that you refer to but i think we have a number of resources we need through the defense authorization act mental health services are mandated to reach out to the committee in mandate through

the community spirit professionals and their businesses the law require you to hire them. >> i don't know if we are required but we are reaching out more with the v.a. services i had that discussion with our office and we are looking for ways to ring gauge the individuals further. >> i was told a community mental health center could not be reimbursed for any services provided by a family or marriage therapist that does not make sense based on what you said i know there is a noted - - they're trying to integrate that the community health centers says they cannot use marriage therapist to be reimbursed. >> i will have to look more specifically. >> sorry i was running late.

i will not talk long but for the support for two bills with the bill 1754 i don't thank you have taken a position but i think it is the valuable resource with the claims ' in the appeal process also senator gramm's bill 2022 gore like to see them make their way through the committee. i don't thank you have anything to do with the toxic waste issue private forward to a meeting to get some answers. thank you. >> dr. it is good to see you again.

to the issues of alaska i appreciate your support for our hearings in the state that our helpful to you and your team and to me and my team and i was here last we talked about the doctors six points with regard to the alaska plan and pilot program but everybody recognizes has been a problem in terms of the implementation of the choice that i appreciate you following up the minor understanding is most of what the doctor will do is

for most of that we will not need legislation in. but particularly from the call yesterday from that pilot project in terms of partnerships you might need legislative authority i just want to get a commitment you will work with my team here to make sure we know what that is a whatever bills are moving to make sure that is in hand. >> yes, sir. >> just because you saw how passionate our veterans were on the issue i just want to work through the time line on the issues in alaska as you saw our urgent those issues are and i talked

about the ability for you to move up the time line. can i get a commitment as soon as possible to work with you to announce what we will do in terms of the alaska up plan in the area where you have authority we talked yesterday about two phases one we have already implemented a virtual integration between tri-west and integrated care service so there is a direct connection between those individuals of v.a. alaska we have worked for a long time with those providers. tri-west is recruiting seven additional individuals to be physically present in the center what came across

yesterday make sure we do this right with the right people right now we think they're in place by mid november. >> there is no way to move that up? >> they're moving as quickly as possible. they want this almost as bad as you do. >> i doubt that. maybe they do we're trying to work together. >> bear very committed to the veterans and the vendors that are working with them and in the thing they can do to facilitate the communication to make that work is something they will push as quickly to put together a good service it will be implemented in other places we want to make sure it is successful. >> i appreciate the constructive answer.

we're still getting a lot of veterans calling in on this issue about what would be useful is have them speak directly to you. to see if you can answer a question that the is the veteran works at the v.a. but the alaska v.a. takes pride of service to veterans the spending dozens of hours on the phone but the contractor shortcomings the employees cannot do the jobs they are hired to do because they spend so much time on resolving the choice act issues. rand and will throw in one more. a board certified doctor in anchorage said as a disabled

veteran he is providing care 1,036 patients out of 7,994 but in last several weeks he could only see to out of 100 from the implementation. will that address these issues that are coming directly from the veterans? >> illustrated the point i just made that people in the integrated care service center care as much as you do to serve the veteran to resolve those problems to work efficiently to reestablish what is important witches' relationships between the benders you make my point as well as your point. >> so does the plan allowed

these to be fixed? >> i think it will. >> the key to the panelist for their testimony in the second panel may come forward now. [inaudible conversations] [inaudible conversations] [inaudible conversations]

still read before i introduce the panel thinks to the region than the vfw and all the others over the past 78 months we have had a difficult situation in denver and want to thank the ranking member as well because of the support and the cooperation of the ranking member we pulled off something nobody thought wewe pf something nobody thought we could do to find the money to finish the hospital without going outside the v.a. that the obvious those were extremely helpful in the waning days of the debate i want you to tell

your commanders the same but in those last minutes she stuck behind the committee and we appreciate that very much. >> also thanks for your leadership although i am not share - - third icahn will scorer with this trilogy your testimony. [laughter] but second to emphasize how important the veteran service organization has been and the most telling word in that title is service you truly have been a service as well as all of us to have a responsibility to provide for them and the partnership we have is enormously beneficial. we're trying as hard as we

can to serve the common goal so i hope he will pass that message along to your leadership and membership because they truly deserve credit for helping a survey of veterans of america and their service to our country in uniform. >> i'll introduce the second panel, the legislative session iraq and afghanistan veterans of america. the director of veterans affairs of the rehabilitation division of the american legion. principal associated and the national legislative vice-chairman we appreciate you to be here today.

>> chairman and ranking member and distinguished members of the committee we would like to thank you for your kind brought them the opportunity to show this legislation having established that i will focus my testimony on to areas to increase access to health care and mental health care and eliminate homelessness. that is a top priority for our rivers according to the survey 40 percent of respondents who had died by suicide in 47% at least one veteran attempted suicide rather were conducted by this committee is really appreciated there is a much more work to be done. first and foremost, the need to ensure the act is appropriately enacted to urge the committee to hold the oversight hearing before the year 2015 we recognize

we have been a disservice specifically trained to understand what the evidence based treatments to prove effective there is no question to be leading experts the better in specific care and services to webber many do choose to seek care outside of the system according to the 2014 member survey 50 percent of respondents cite health care which is a sizable percentage and in light of that we support the of lying to identify nine health care providers to foster a greater awareness of best practices appear along providers will strengthen the overall care available to veterans. we encourage members of this committee to recognize the potential benefit to connect to veterans to a network of providers. to to ensure greater access must remain a top priority

in order to prevent a repeat of the egregious situation it came to light out of phoenix. with the foundation of change to understand the support of numerous positions to build on these initiatives with those medical residencies it is currently included to impact the ability to utilize its position it will give the v.a. the ability to utilize the increase in the manner it was intended. and additionally the behavioral health residencies to encourage the committee to use the pilot program across the entire country.

to address to end homelessness. now there is a need to address concerns and moving forward in homelessness in light of this to sustain permanent housing end of the provisions include to fall into homelessness. to end homelessness for those facing similar issues. to reinforce the area and

greatly affected by the issue of a strong supporter of oversight we understand under the leadership of secretary mcdonald is to create a strong community for veterans it is time they use the support for the original purpose. we are in close contact with remembers a yankee activist on the ground. listening to their concerns there may be a special status granted to the stadium it is imperative they work to address this issue there is no competing directives and care remain a priority. of veterans to serve the best and it comes to filling the promise of the military. . .

to thank and congratulate this committee and especially the leadership here today for their excellent bipartisan efforts to have been numbed by the constant drone of negative effect. the most comprehensive bill being considered today